NPI | 1619317583 |
---|---|
Former Name | JESSICA TILMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009629) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P008181) |
Enumeration Date | 2013-06-25 |
Last Update Date | 2020-10-30 |